Managing Actuary (Medicaid Rate Advocacy)

About the Role

Given the complexity of healthcare and managed care, this role is crucial in ensuring that the company navigates the regulatory and financial aspects of Medicaid effectively. The ideal candidate will have a deep understanding of actuarial processes, including pricing, forecasting, and reserving, as well as experience in managing and leading teams.

What You Will Do

• Develop and maintain complex actuarial models to support business goals, including actual to expected experience reporting, actuarial reserves, and accruals.
• Provide actionable and strategic recommendations to leadership based on thorough analysis of financial data and trends.
• Lead the development and review of Incurred But Not Reported (IBNR) reserve estimates for all lines of business on a monthly basis.
• Oversee baseline analysis on expectations of rate changes for future years and collaborate with federal and state agencies to support rate filings.
• Manage the development and maintenance of contracting models and ensure compliance with regulatory requirements.
• Perform peer reviews and audits to ensure the quality and accuracy of actuarial work.
• Develop and implement process improvements to increase efficiency and reduce risk.
• Collaborate with cross-functional teams, including finance, operations, and compliance, to ensure aligned strategies and goals.
• Stay updated on industry trends, regulatory changes, and emerging technologies that could impact actuarial models and processes.

What We Are Looking For

• Bachelor's degree in Actuarial Science, Mathematics, Economics, or a related field.
• Associate of the Society of Actuaries (ASA) certification is required; Fellow of the Society of Actuaries (FSA) is preferred.
• At least 2-3 years of experience in actuarial work, with a preference for experience in Medicaid Rate Advocacy.
• Strong proficiency in Excel and experience with database management tools such as SQL or SAS.
• Excellent written and verbal communication skills, with the ability to present complex data insights to both technical and non-technical stakeholders.
• Proven leadership and management skills, with experience in motivating and developing team members.
• Ability to work in a fast-paced environment and meet deadlines while maintaining high-quality work.

Nice to Have

• Experience in managed care or healthcare, particularly in roles involving rate setting, financial forecasting, or regulatory compliance.
• Knowledge of programming languages such as R or Python, and experience with data visualization tools.
• Certification in data science or a related field, demonstrating a commitment to ongoing learning and professional development.

Benefits and Perks

• Competitive salary range, taking into account education, training, experience, and the position's scope and complexity.
• Bonus tied to company and individual performance, providing opportunities for financial growth based on achievements.
• Comprehensive total rewards package, including health benefits, retirement plans, and paid time off, to support overall well-being.
• Opportunities for professional development and growth within the company, including training programs and mentorship initiatives.
• Remote work arrangements, allowing for flexibility and work-life balance.
• Access to cutting-edge technology and tools to support actuarial work and professional development.
• Collaborative and dynamic work environment, with a team committed to excellence and innovation.

• Ensure your resume and cover letter highlight your experience in actuarial science, particularly in Medicaid Rate Advocacy, and your proficiency in tools like Excel and SQL.
• Prepare examples of actuarial models you've developed and maintained, and be ready to discuss your approach to data analysis and strategic planning.
• Show a deep understanding of the healthcare sector, especially in managed care, and stay updated on regulatory changes and industry trends.
• Highlight your leadership and management skills, including experience in motivating team members and managing complex projects.
• Be prepared to discuss your certification status and ongoing professional development, such as pursuing Fellow of the Society of Actuaries (FSA) certification.
• Consider creating a portfolio of your work, including any publications, presentations, or successfully implemented projects, to demonstrate your expertise to potential employers.
• When negotiating salary, research the market rate for actuarial positions in the healthcare sector and be prepared to discuss your expectations based on your experience and qualifications.